The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

AIM:To analyze the expression of se-creted phosphoprotein 1(SPP1)and programmed cell death-ligand 1(PD-L1)in SMARCA4-deficient non-small cell lung cancer,and to provide a scientif-ic basis for the study of the follow-up treatment of this rare pathological type of lung cancer.METH-ODS:The clinical and pathological characteristics of 12 patients with this disease were analyzed retro-spectively,and the patients were divided into two groups of adenocarcinomas and poorly differentiat-ed carcinomas according to their morphological characteristics,and the relationship between the expression of SPP1 and PD-L1 was analyzed in the two groups.RESULTS:SPP1 expression was detect-ed in all patients and Its expression level was signif-icantly higher in the poorly differentiated carcino-ma group compared with the adenocarcinoma group(P=0.015);PD-L1 expression was found in 6/7 patients(5 cases were not measured),compared with the adenocarcinoma group,PD-L1 was also highly expressed in the poorly differentiated carci-noma group(P=0.048)and the PD-L1 difference be-tween the two groups suggested that the results were similar to those of SPP1.CONCLUSION:SMARCA4-deficient non-small cell lung cancer has high positive expression of SPP1 and PD-L1.It was more pronounced in patients with poorly differenti-ated carcinoma.There may be a positive correla-tion between SPP1 and PD-L1 expression in SMAR-CA4-deficient non-small cell lung cancer and the mechanism of the correlation needs to be further verified in subsequent studies.

AIM: To analyze the changes of retinal structure and function before and after panretinal photocoagulation(PRP)in patients with proliferative diabetic retinopathy(PDR).METHODS: Prospective study. Totally 98 cases(98 eyes)of PDR patients who underwent PRP in Eye Hospital of Wenzhou Medical University from January 2022 to May 2023 were included. Optical coherence tomography angiography(OCTA)was used to detect central retinal thickness(CRT), central macular thickness(CMT), subfoveal choroidal thickness(SFCT), foveal avascular zone(FAZ), deep vascular complex(DVC)blood flow density, superficial vascular complex(SVC)blood flow density before and at 1 wk, 1 and 3 mo after PRP. During the follow-up, 1 eye underwent vitrectomy, 2 eyes were lost to follow-up, and finally 95 eyes completed 1 a follow-up, with a loss rate of 3%. According to the visual prognosis at 1 a after treatment, the patients were divided into two groups: 73 eyes in good prognosis group and 22 eyes in poor prognosis group(including 9 eyes of visual disability and 13 eyes of visual regression). The changes in retinal structure and function before and after PRP treatment were compared between the two groups of patients, and the receiver operating characteristic(ROC)curve and decision curve were used to analyze the predictive value of retinal structure and function for PDR treatment.RESULTS: There were statistical significant differences in PDR staging, CRT, CMT, SFCT, DVC blood flow density, and SVC blood flow density between the two groups of patients before treatment(all P<0.05). At 1 wk, 1 and 3 mo after treatment, the FAZ area of both groups decreased compared to before treatment, while the blood flow density of DVC and SVC increased compared to before treatment(both P<0.05). However, there was no significant difference in the blood flow density of FAZ, DVC, and SVC between the two groups at 1 wk, 1 and 3 mo after treatment(all P>0.05). The CRT, CMT and SFCT of the two groups at 1 wk after treatment were higher than those before treatment(all P<0.05), but there were no significant differences between the two groups(all P>0.05). The CRT, CMT and SFCT at 1 and 3 mo after treatment were lower than those at 1 wk after treatment and before treatment in both groups. The CRT, CMT and SFCT in the poor prognosis group at 3 mo after treatment were higher than those at 1 mo after treatment, and were higher than those in the good prognosis group(all P<0.05). ROC analysis showed that, at 3 mo after laser treatment in PDR patients, the area under the curve of the CRT, CMT, and SFCT alone or in combination after treatment for 1 a was 0.788, 0.781, 0.783, and 0.902, respectively, and the combined prediction value was better(P<0.05). Decision curve analysis showed that the combined detection of CRT, CMT, and SFCT in PDR patients at 3 mo after treatment can improve the predictive value of visual prognosis.CONCLUSION: The optimal time for retinal structure and function recovery in PDR patients after PRP treatment is between 1 wk and 1 mo. OCTA measurement of CRT, CMT, and SFCT at 3 mo after treatment can predict the visual prognosis during the 1 a treatment period.

Objective:To investigate the mechanism of Fusobacterium nucleatum ( Fn) in regulating the formation of neutrophil extracellular trap (NET) to aggravate colitis. Methods:With a completely randomized design, 15 C57BL/6 mice were randomly divided into negative control group, dextran sulfate sodium (DSS) A group (DSS-induced colitis), and DSS+ Fn A group (DSS-induced colitis with Fn infection); another 15 C57BL/6 mice were randomly divided into DSS B group, DSS+ Fn B group, and GSK484 group (DSS-induced colitis with Fn infection and followed by intraperitoneal injection of peptidylarginine deiminase 4 (PAD4)inhibitor GSK484), with 5 mice in each group. The Fn-infected neutrophils (HL-60 cell) model and PAD4-inhibited cell model were established and divided into neutrophil-like control cell (induced with 1.25% dimethylsulfoxide), Fn+ neutrophil-like cell (neutrophil-like cells co-cultured with Fn), and GSK484 cell ( Fn+ neutrophil-like cell co-cultured with GSK484) with a completely randomized design. The neutrophil-like control and Fn+ neutrophil-like cells were divided into 2 batches to conduct experiments before and after PAD4 inhibition separately.The expression of zonula occludens-1 (ZO-1), neutrophil elastase (NE), reactive oxygen species, PAD4, and citrullinated histone H3(cit-H3) were analyzed by immunohistochemistry staining, Western blotting, and flow cytometry assay. Two-tailed t test was used for statistical analysis. Results:The results of immunohistochemical staining showed that compared with those of the DSS A group, the expression levels of NE, PAD4 and cit-H3 of the DSS+ Fn A group were upregulated, and the expression level of ZO-1 was downregulated; compared with those of the DSS+ Fn B group, the expression level of ZO-1 of the GSK484 group was upregulated, and the expression levels of cit-H3 and PAD4 were downregulated. The results of Western blotting demonstrated that, before the PAD4 inhibition, the expression levels of NE, PAD4 and cit-H3 of the Fn+ neutrophil-like cell were all higher than those of the neutrophil-like control cell (1.52±0.11 vs. 1.00±0.19, 1.21±0.06 vs. 1.00±0.07, 1.59±0.16 vs. 1.00±0.16), and the differences were statistically significant ( t=-4.13, -3.86, and -4.47; P=0.014, 0.014, and 0.018); after the PAD4 inhibition, the expression levels of PAD4, cit-H3, and NE of the GSK484 cell were all lower than those of the Fn+ neutrophil-like cell (0.95±0.09 vs. 1.27±0.04, 1.15±0.34 vs. 2.29±0.50, 1.22±0.14 vs. 1.68±0.12), and the differences were statistically significant ( t=5.61, 3.24, and 4.49; P=0.005, 0.032, and 0.011). The results of flow cytometry assay indicated that the positive rate of reactive oxygen species of the DSS+ Fn A group was higher than that of the DSS A group ((21.15±2.93)% vs. (11.14±1.42)%), and the positive rate of reactive oxygen species of the Fn+ neutrophil-like cell was also higher than that of the neutrophil-like control cell before the PAD4 inhibition ((51.69±6.94)% vs.(31.95±3.31)%), and the differences were statistically significant( t=5.33 and 4.45, P=0.006 and 0.011). Conclusion:Fn can promote neutrophil to release NET by upregulating reactive oxygen/PAD4/cit-H3 signaling pathway, which disrupt the intestinal barrier and aggravate colitis.

Objective:To evaluate the technical feasibility and perioperative safety of pyeloplasty assis-ted by the CarinaTM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction(UPJO).Methods:From November to December 2024,five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the CarinaTM modular laparoscopic surgical system at Peking University First Hospital.Data on patient demographics,intraoperative parameters(including docking time,console time,and estimated blood loss),perioperative outcomes,follow-up results,and surgeons' subjective evaluations of system performance were prospectively collected.Descriptive statistics were used;continuous variables were presented as median(range),and categorical variables as frequen-cy and percentage.Results:The cohort included four females and one male.All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery.The me-dian age was 32 years(24-37 years),and the median body mass index was 21.6 kg/m2(15.8-27.3 kg/m2).The median docking time was 8 min(3-12 min),and the median console time was 91 min(71-125 min).Intraoperative blood loss was uniformly 20 mL.The median postoperative drainage du-ration was 3 d(0-4 d),and the median length of hospital stay was 4 d(4-9 d).No Clavien-Dindo grade Ⅲ or higher complications occurred.All the patients had their double-J stents removed at 2 months postoperatively,and pain in the ipsilateral flank,reported preoperatively by all the five patients,was al-leviated.The subjective surgical success rate was 100％.Surgeons reported stable system performance throughout all the procedures,with no instances of mechanical arm interference or visual drift affecting surgical fluency.Conclusion:Preliminary findings indicate that pyeloplasty using the domestically deve-loped CarinaTM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

Objective:It aims to reveal the direct and indirect effects of the configuration of multiple influencing factors on the expansion and downward transfer of high-quality medical resources on medical expenses,providing a scientific basis for formulating differentiated policies based on local conditions.Methods:Based on the policy diffusion theory,combined with qualitative comparative analysis and regression analysis methods,a complex mediation model is constructed to deeply analyze the complex relationship and mechanism between the expansion and downward transfer of high-quality medical resources and the control of per capita medical expenses.Results:(1)There are multiple equivalent configuration paths that can promote the expansion and downward transfer of high-quality medical resources,among which three configuration paths are driven by public demand,government attention,and financial guarantee,and two configuration paths are driven by infrastructure and financial guarantee;(2)The expansion and downward transfer of high-quality medical resources play a complex mediating role in the impact of multiple equivalent configuration paths on per capita medical expenses.Conclusion:In the process of implementing the expansion and downward transfer of high-quality medical resources,localities should scientifically choose implementation paths suitable for local conditions;build a multi-level and multi-dimensional policy combination system;strengthen financial input and fund guarantee to provide a solid economic foundation for the expansion and downward transfer of high-quality medical resources.

Objective:To evaluate the technical feasibility and perioperative safety of pyeloplasty assis-ted by the CarinaTM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction(UPJO).Methods:From November to December 2024,five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the CarinaTM modular laparoscopic surgical system at Peking University First Hospital.Data on patient demographics,intraoperative parameters(including docking time,console time,and estimated blood loss),perioperative outcomes,follow-up results,and surgeons' subjective evaluations of system performance were prospectively collected.Descriptive statistics were used;continuous variables were presented as median(range),and categorical variables as frequen-cy and percentage.Results:The cohort included four females and one male.All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery.The me-dian age was 32 years(24-37 years),and the median body mass index was 21.6 kg/m2(15.8-27.3 kg/m2).The median docking time was 8 min(3-12 min),and the median console time was 91 min(71-125 min).Intraoperative blood loss was uniformly 20 mL.The median postoperative drainage du-ration was 3 d(0-4 d),and the median length of hospital stay was 4 d(4-9 d).No Clavien-Dindo grade Ⅲ or higher complications occurred.All the patients had their double-J stents removed at 2 months postoperatively,and pain in the ipsilateral flank,reported preoperatively by all the five patients,was al-leviated.The subjective surgical success rate was 100％.Surgeons reported stable system performance throughout all the procedures,with no instances of mechanical arm interference or visual drift affecting surgical fluency.Conclusion:Preliminary findings indicate that pyeloplasty using the domestically deve-loped CarinaTM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

Objective:It aims to reveal the direct and indirect effects of the configuration of multiple influencing factors on the expansion and downward transfer of high-quality medical resources on medical expenses,providing a scientific basis for formulating differentiated policies based on local conditions.Methods:Based on the policy diffusion theory,combined with qualitative comparative analysis and regression analysis methods,a complex mediation model is constructed to deeply analyze the complex relationship and mechanism between the expansion and downward transfer of high-quality medical resources and the control of per capita medical expenses.Results:(1)There are multiple equivalent configuration paths that can promote the expansion and downward transfer of high-quality medical resources,among which three configuration paths are driven by public demand,government attention,and financial guarantee,and two configuration paths are driven by infrastructure and financial guarantee;(2)The expansion and downward transfer of high-quality medical resources play a complex mediating role in the impact of multiple equivalent configuration paths on per capita medical expenses.Conclusion:In the process of implementing the expansion and downward transfer of high-quality medical resources,localities should scientifically choose implementation paths suitable for local conditions;build a multi-level and multi-dimensional policy combination system;strengthen financial input and fund guarantee to provide a solid economic foundation for the expansion and downward transfer of high-quality medical resources.

AIM:To analyze the expression of se-creted phosphoprotein 1(SPP1)and programmed cell death-ligand 1(PD-L1)in SMARCA4-deficient non-small cell lung cancer,and to provide a scientif-ic basis for the study of the follow-up treatment of this rare pathological type of lung cancer.METH-ODS:The clinical and pathological characteristics of 12 patients with this disease were analyzed retro-spectively,and the patients were divided into two groups of adenocarcinomas and poorly differentiat-ed carcinomas according to their morphological characteristics,and the relationship between the expression of SPP1 and PD-L1 was analyzed in the two groups.RESULTS:SPP1 expression was detect-ed in all patients and Its expression level was signif-icantly higher in the poorly differentiated carcino-ma group compared with the adenocarcinoma group(P=0.015);PD-L1 expression was found in 6/7 patients(5 cases were not measured),compared with the adenocarcinoma group,PD-L1 was also highly expressed in the poorly differentiated carci-noma group(P=0.048)and the PD-L1 difference be-tween the two groups suggested that the results were similar to those of SPP1.CONCLUSION:SMARCA4-deficient non-small cell lung cancer has high positive expression of SPP1 and PD-L1.It was more pronounced in patients with poorly differenti-ated carcinoma.There may be a positive correla-tion between SPP1 and PD-L1 expression in SMAR-CA4-deficient non-small cell lung cancer and the mechanism of the correlation needs to be further verified in subsequent studies.